The effect of melatonin on the lipid levels in menopausal women: A double-blind, controlled, clinical trial.

BACKGROUND: Cardiovascular diseases are the major public health problem in many countries and are responsible for more than half of the deaths in above 50-year-old women. The most common curable risk factor of these disorders is hypoestrogenemia resulting from menopause. The present study aimed to investigate the effect of melatonin on plasma lipid levels in menopausal women. MATERIALS AND METHODS: The present double-blind, placebo-controlled, clinical trial was conducted in 2013-2014 on 240 menopausal women between 40 and 60 years old referring to the Gynecology and obstetrics clinics of Shiraz University of Medical Sciences who were randomly divided into two groups. The intervention group received 3 mg melatonin tablets and the control group received the placebo for 3 months. The data were gathered using the demographic information questionnaire and lipid profile test before and 3 months after the intervention. Then, the data were analyzed through the SPSS statistical software (version 16). The repeated measures analysis of variance, the least significant difference, the independent-sample t, the Chi-square, and Fisher's exact tests were done for data analysis. RESULTS: The two study groups were similar regarding the demographic and clinical variables at the beginning of the study. In the melatonin group, the amount of triglyceride increased from 140.34 ± 48.29 before the study to 151.24 ± 54.60 3 months after the intervention and no significant difference was observed between the two groups in this regard (confidence interval [CI] = 95%, P > 0.05). In addition, no significant difference was found between the two groups concerning low-density lipoprotein cholesterol level (CI = 95%, P = 0.125). CONCLUSION: Melatonin was not effective in reduction of lipid levels. However, further controlled studies are needed to be conducted on the issue.

Comparison of the Effect of Vaginal Zataria multiflora Cream and Oral Metronidazole Pill on Results of Treatments for Vaginal Infections including Trichomoniasis and Bacterial Vaginosis in Women of Reproductive Age.

Effect of Zataria multiflora on bacterial vaginosis and Trichomonas vaginalis is shown in vivo and in vitro. We compare the effectiveness of Zataria multiflora cream and oral metronidazole pill on results of treatment for vaginal infections including Trichomonas and bacterial vaginosis; these infections occur simultaneously. The study included 420 women with bacterial vaginosis, Trichomonas vaginalis, or both infections together, who were randomly divided into six groups. Criteria for diagnosis were wet smear and Gram stain. Vaginal Zataria multiflora cream and placebo pill were administered to the experiment groups; the control group received oral metronidazole pill and vaginal placebo cream. Comparison of the clinical symptoms showed no significant difference in all three vaginitis groups receiving metronidazole pill and vaginal Zataria multiflora cream. However, comparison of the wet smear test results was significant in patients with trichomoniasis and bacterial vaginosis associated with trichomoniasis in the two treatment groups (p = 0.001 and p = 0.01). Vaginal Zataria multiflora cream had the same effect of oral metronidazole tablets in improving clinical symptoms of all three vaginitis groups, as well as the treatment for bacterial vaginosis. It can be used as a drug for treatment of bacterial vaginosis and elimination of clinical symptoms of Trichomonas vaginitis.

Comparing the effects of aerobic and stretching exercises on the intensity of primary dysmenorrhea in the students of universities of bushehr.

OBJECTIVE: To compare the effects of aerobic and stretching exercises on severity of primary dysmenorrhea. MATERIALS AND METHODS: This randomized clinical trial was conducted on 105 female students who were suffering from primary dysmenorrhea. The participants were divided into aerobic exercise, stretching exercise, and control groups. The two intervention groups did the exercises three times a week for eight weeks (two menstrual cycles). The intensity of dysmenorrhea was determined using a modified questionnaire that assessed several symptoms of dysmenorrhea. After all, the data were compared between and within groups through analysis of variance. RESULTS: Before the intervention, the mean intensity of dysmenorrhea was 40.38 ± 5.5, 37.40 ± 3.8, and 38.45±3.3 in aerobic, stretching, and control groups, respectively, but the difference was not statistically significant. After the intervention, however, a significant difference was found among the three groups regarding the mean intensity of dysmenorrhea in the first and second menstrual cycles. Also, a significant difference was observed between the aerobic group and the control group as well as between the stretching group and the control group. Within group comparisons showed a significant difference in the aerobic and the stretching group before and after the interventions. However, no such difference was observed in control group. CONCLUSION: Both aerobic and stretching exercises were effective in reducing the severity of dysmenorrhea. Therefore, women could choose one of these two methods with regard to their interest and lifestyle.

The Effect of Melatonin on Climacteric Symptoms in Menopausal Women; A Double-Blind, Randomized Controlled, Clinical Trial.

BACKGROUND: Menopause is one of the most critical periods of woman's life. With reducing of ovarian estrogen; women are more prone to psychological and physical symptoms. The present study aimed to investigate the effect of melatonin on the climacteric symptoms. METHODS: The present double blind, placebo randomized controlled clinical trial was conducted on 240 menopausal women (40 - 60 years old) referring to the gynecology clinics of Shiraz University of Medical Sciences (January - November 2012). The participants were randomly divided into two groups through sortition. Demographic characteristics, Goldberg's general health questionnaire (GHQ), Greene Climacteric Scale and level of Follicle Stimulating Hormone (FSH) were determined for both groups before the intervention. The intervention group received one 3mg melatonin tablet each night for 3 months and the control group received the placebo in the same period. Changes of climacteric symptoms and drug complications were measured 1, 2 and 3 months after the intervention. RESULTS: We analyzed the data of 99 postmenopausal women in the intervention group and 101 postmenopausal women in the control group. In the melatonin group, the climacteric symptoms score decreased from 35.73+11.6 to 17.09+10.22 during the 3-month study period and regardless of time, a significant difference was observed between the two groups (P<0.001). In addition, a significant difference was found between the two groups regarding various dimensions of the climacteric symptoms over time (P<0.001). No significant difference was found regarding side effects between the two groups (P= 0.135). CONCLUSION: The study findings showed that using melatonin improved the climacteric symptoms.

The Effect of Mefenamic Acid and Naproxen on Heavy Menstrual Bleeding: A Placebo-Controlled Study

Background. Heavy menstrual bleeding is a common complaint. Various therapeutic approaches have been suggested.Aim. To compare the efficacy of mefenamic acid and naproxen in reducing heavy menstrual bleeding.Methods. Women referred to an outpatient centre for treatment of heavy menstrual bleeding were recruited. Participants who met the inclusion criteria were evaluated for 6 menstrual cycles. During 3 control cycles they recorded the amount of their bleeding on the Pictorial Blood Assessment Chart to confirm that their menstrual bleeding was heavy. One hundred and twenty participants were then randomly assigned to receive mefenamic acid; naproxen or placebo; and asked to fill in the same questionnaires during 3 intervention cycles. The data were analysed using SPSS version 15 for Windows.Results. Participants receiving mefenamic acid experienced a marked decrease in bleeding during the 3 months of intervention; an initial sharp decrease being followed by a further lesser decrease (p0.05 within group). Bleeding lessened dramatically in the first month of the intervention in participants receiving naproxen; and dropped still further in the second and third months (p0.05 within group). In the placebo group there were slight changes in bleeding during the intervention (p0.05 within group). However; the total decrease in bleeding was greatest in the naproxen arm; and the differences between the groups were statistically significant (p0.05 between groups).Conclusion. All three interventions had positive effects on the mean amount of bleeding; although naproxen was more effective than mefenamic acid and much more effective than placebo

Effect of St John's wort on severity, frequency, and duration of hot flashes in premenopausal, perimenopausal and postmenopausal women: a randomized, double-blind, placebo-controlled study.

OBJECTIVE: Because of a decline in estradiol levels, premenopausal, perimenopausal, and postmenopausal women experience symptoms related to vasomotor instability. Certain plants have been found to have molecular components that are identical in structure and function to human hormones. We conducted this study to compare the efficacy of St John's wort with that of placebo in women with hot flashes. METHODS: A total of 100 women participated in a clinical trial conducted in an academic medical center in Shiraz-Iran. Women were treated with St John's wort extract or placebo for 8 weeks. Climacteric complaints were evaluated by using the Blatt-Kupperman Index at two follow-up visits. Statistical analysis was carried out by using descriptive statistics and multivariate analysis. RESULTS: The mean age of the participants was 50.4 years. Both groups responded to the interventions, and the within-group differences in frequency, duration, and severity of hot flashes were statistically significant (P < 0.05). The difference in duration of hot flashes between groups was not significant on the 4th week of intervention (P = 0.27); however, it was statistically significant between the two groups on the 8th week of treatment (P < 0.001). The fall-off in frequency of hot flashes on the 4th and 8th weeks of intervention was more evident in women receiving St John's wort, and the differences between groups were statistically significant (P = 0.005 and P < 0.001, respectively). Furthermore, comparing both study groups, we showed that the decrease in the severity of flashes in women who received St John's wort was more evident on the 4th and 8th weeks (P = 0.004 and P < 0.001, respectively). CONCLUSIONS: St John's wort can be used as an effective treatment for the vasomotor symptoms of perimenopausal or postmenopausal women.

Comparison of Pap smear quality with anatomical spatula and convenience (spatula-cytobrush) methods: a single blind clinical trial.

OBJECTIVES: The Papanicolaou smear is a standard test for cervical cancer screening; however, the most important challenge is high false negative results. Several factors contribute to this problem and one the most important is inappropriate sampling. The aim of this study was to compare the quality of smears obtained by either an anatomical spatula or a spatula-cyto brush. METHODS: One hundred married women participated in this single blind clinical trial. After all participants were interviewed, two samples were obtained from each: one with a spatula-cytobrush and another with an anatomical spatula. Slides were prepared and assessed by two pathologists for kappa coefficient analysis. RESULTS: Cell adequacy was 96.1 % in anatomical spatula method and 91.2 % in spatula-cyto brush method (p= 0.016). The rates for endocervical cells and metaplasia cells were 70.6%and 24.5%, respectively, with the anatomical spatula method and 69.6% and 24.5% using a spatula-cytobrush (p<0.001). No one reported pain and the amount of bleeding was 38.2% in both methods (p>0.05). In addition, there were no statistically significant differences regarding infection and inflammatory reactions (p>0.05). CONCLUSION: Based on the findings of this study, the results of sampling with anatomical spatula were more acceptable and better than those of spatula-cytobrush sampling.

Effect of treatment with dydrogesterone or calcium plus vitamin D on the severity of premenstrual syndrome.

OBJECTIVE: To compare the effects of dydrogesterone and calcium plus vitamin D in women with severe premenstrual syndrome (PMS). METHOD: In this randomized, double-blind, placebo-controlled study, 180 Shiraz University students with PMS used questionnaires daily to rate their symptoms for 2 menstrual cycles. Then, the students were randomly assigned to take a tablet containing either 5 mg of dydrogesterone, 500 mg of calcium plus 200 mg of vitamin D, or a placebo twice daily from the 15th to the 24th day of the cycle for 2 more cycles, and to use the same questionnaires during the intervention cycles. The collected data were then analyzed by repeated-measurement design and multilevel modeling tests. RESULT: Treatment with dydrogesterone or calcium plus vitamin D decreased symptom severity in a similar way (by 4.64% and 4.20%, respectively) and placebo was associated with a 3.42% decrease. CONCLUSION: Treatment with dydrogesterone or calcium plus vitamin D had a similar effect on symptom severity in women with PMS.

Comparison of Carnoy's solution and 96% ethyl alcohol fixation in bloody Pap smears.

OBJECTIVE: To compare 2 methods of fixation in bloody Pap smears with Carnoy's solution and 96% ethyl alcohol. STUDY DESIGN: After observation of contact bleeding, 2 samples were prepared from cervical cells with conventional Pap smear. One sample was fixed in 96% ethyl alcohol and another sample was fixed in Carnoy's solution. RESULTS: Of 450 slides, 410 were selected for study. In study of cell adequacy, diagnosis of squamous cells and glandular cells was better in Carnoy's-fixed slides. Blood contamination of slides was reduced in Carnoy's-fixed slides (13.85% vs. 49.51%), and clearance of slides was increased in Carnoy's-fixed slides. Diagnosis of inflammatory cells and pathogenic microorganisms in was increased in Carnoy's-fixed slides, but no difference was seen in diagnosis of epithelial cell and glandular cell abnormalities. CONCLUSION: Carnoy's solution can be used as an effective fixative in bloody smears in conventional Pap tests.